Approved therapies in the IgA nephropathy armamentarium: a summary of the evidence.
A review of the five newer approved IgA nephropathy medicines, Nefecon, sparsentan, iptacopan, atrasentan and sibeprenlimab, and the trial evidence behind each.
Background
IgAN was historically managed with supportive care, with 6 months of immunosuppression considered for high-risk patients with persistent proteinuria despite optimised care.
Key findings
Nefecon (targeted-release budesonide) acts on gut mucosal production of galactose-deficient IgA1 and slowed eGFR decline in phase 3. Sparsentan reduced proteinuria and eGFR decline versus irbesartan. Iptacopan (factor B inhibitor), atrasentan (endothelin A antagonist) and sibeprenlimab (APRIL inhibitor) received accelerated FDA approval on interim proteinuria reductions versus placebo.
Clinical implications
The expanded armamentarium allows treatment targeting both IgAN immunology and generic nephron loss, giving clinicians and patients more choice.
Category
Research
Source
Kidney International Supplements
More from ASNRT News
Browse the latest news, society announcements, KDIGO guideline updates, and AJNT issue releases on the ASNRT newsroom.